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Organization
SOUTHERN MENTALITY PLLC
Active
Organization
SOUTHERN MENTALITY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE JANE THOMPSON PMHNP (CEO, OWNER, NURSE PRACTITIONER)
(603) 505-2922
Entity
Organization
Contact information
Practice address
1914 J N PEASE PL, CHARLOTTE, NC 28262-4504
(704) 754-8718
(704) 803-5923
Mailing address
1914 J N PEASE PL, CHARLOTTE, NC 28262-4504
(704) 754-8718
(704) 803-5923
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/20/2023
Last updated
01/07/2025
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